Ex-medical journal
editor reveals
drug firms' dirty tricks

IAN JOHNSTON
SCIENCE CORRESPONDENT

http://unhivedmind.14.freebb.com
http://thescotsman.scotsman.com/health.cfm?id=536012005

PHARMACEUTICAL companies are using their massive financial clout to corrupt medical journals by rigging clinical trials of new drugs, it was claimed today.

Richard Smith, former editor of the British Medical Journal (BMJ), has exposed a series of tricks used by drug firms to ensure good publicity for new products in prestigious journals. He said it was often impossible for editors of the journals to spot a rigged trial - despite the process of "peer review" where research is checked independently - and also highlighted a "conflict of interest" because publishing trials by major drug companies would result in increased sales.

The Association of the British Pharmaceutical Industry denied the allegations, saying it would make no sense to rig trials because they would eventually be "found out".

Writing in the online journal PLOS [Public Library of Science] Medicine, Mr Smith, who is now chief executive of private firm UnitedHealth Europe, said action should be taken to ensure journals were not becoming "an extension of the marketing arm of pharmaceutical companies".

"A large trial published in a major journal has the journal’s stamp of approval, will be distributed round the world and may well receive global media coverage," he said. "For a drug company, a favourable trial is worth thousands of pages of advertising.

"The companies seem to get the results [in trials] they want not by fiddling the results, which would be far too crude and possibly detectable by peer review, but rather by asking the ‘right’ questions."

Mr Smith listed various scams including testing a drug against an inferior treatment, testing the company’s new product against too high or too low a dose of another drug, conducting trials on too small a scale or picking and choosing positive results.

"The evidence is strong that companies are getting the results they want and this is especially worrisome because between two-thirds and three-quarters of the trials published in the major journals - Annals of Internal Medicine, Journal of the American Medical Association, Lancet and New England Journal of Medicine - are funded by the industry," Mr Smith said.

The figure was less for his former publication, the BMJ, at about a third, he said.

Editors whose suspicions were aroused might also be compromised by the need to make money. "Publishers know that pharmaceutical companies will often purchase thousands of dollars’ worth of reprints [of the magazine]," Mr Smith said.

"An editor may thus face a frighteningly stark conflict of interest: publish a trial that will bring $100,000 [£54,000] of profit or meet the end-of-year budget by firing [someone]."

He said more clinical trials should be publicly funded and journals should stop publishing them and instead concentrate on critical analysis.

However, the Association of the British Pharmaceutical Industry denied results were being rigged. "In the long run, it’s not in a company’s interest to make claims they know to be untrue," a spokesman said.

"There’s no future in twisting trials’ results because you’ll get found out long before you get to market, and with the costs of lawsuits and so on, it’s just not worth getting it wrong."

No-one from the Lancet was available for comment. Fiona Godlee, editor of the BMJ, welcomed Mr Smith’s comments, adding that "the BMJ takes the issues of transparency very seriously. We continue to call for public registration of all clinical trials and full disclosure of results, regardless of outcome".